Readiness and leadership in evidence-based practice and knowledge management: A cross-sectional survey of nurses’ perceptions

Anne Lunden,Marianne Teräs,Tarja Kvist,Arja Häggman-Laitila

doi:10.1177/2057158520980687

Anne Lunden, Marianne Teräs + Show 2 more

Open Access

https://doi.org/10.1177/2057158520980687

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Abstract

Although research on evidence-based practice (EBP) has been available for several decades, EBP has not been implemented successfully by nursing management. Evidence-based practice is a key area of knowledge management (KM), and EBP and KM are subject to similar challenges. However, there has only been limited research on KM and EBP within the context of nursing. The aim of this study was to describe and explain nurses’ perceptions of their own readiness for EBP, and their perceptions of the managerial and organizational support for enhancing competency and EBP. The study design was a cross-sectional survey carried out in accordance with STROBE. Data were collected from 125 nurses using two international instruments and one instrument developed for this study. The data were then analyzed using descriptive and multivariate statistics. Less than half of the nurses reported that their practices were often evidence-based, and only a third had often searched for evidence. The nurses perceived the weakest areas of management leadership to be arranging resources, solving problems and encouraging discussion in the context of EBP, and anticipation of nurses’ competency needs, ensuring competency and intervening when competency was inadequate in the context of KM. The results emphasize the need to develop nurse training, management leadership and an operational environment conducive to KM and EBP. Managers should take a more visible role in mentoring nurses for EBP and in identifying the developmental needs of nurses’ competencies.

Highlights

Evidence of the factors promoting and preventing EBP2,3 has been collected for several decades, but efforts to utilize it in nursing leadership have failed,[4] and implementation of research evidence in nursing remains poor.[4,5]
The nurses had graduated with an registered nurses (RNs) degree during the period 1974–2017, or with a bachelor’s or master’s degree during the period 1976–2018
The factors explaining ‘nurses’ evidence-based practice (EBP) readiness’ were EBP leadership (b 0.373, 95% CI 0.113–0.633), and transformational knowledge management (KM) (b –0.084, 95% CI –0.268–0.101)

Summary

Introduction

Competency in evidence-based practice (EBP) has been a global goal of nursing ever since the late 1990s.1. Evidence of the factors promoting and preventing EBP2,3 has been collected for several decades, but efforts to utilize it in nursing leadership have failed,[4] and implementation of research evidence in nursing remains poor.[4,5] This means that the target set by the Institute of Medicine[6] of 90% of decision-making being evidence-based by 2020 has not been achieved. Evidence-based practice is the integration of the best available research evidence with clinical expertise, and patients’ values, preferences and clinical circumstances, in decision-making.[4] Nurses’ EBP competencies encompass their knowledge and skills, attitudes and beliefs, about EBP, and their ability to employ EBP.

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